The Science Behind The Ketogenic Diet

If you have read my introduction to the ketogenic diet for cancer and you’re ready to learn more about it, you’re in the right place here! But if you feel you know enough and just want to get on with reading about practical aspects of the diet, go here before you get started.

When I talk about the ketogenic diet, a question that pops up immediately is whether I think that cancer is a metabolic (i.e. a disease that is affected by the way our cells generate energy) or a genetic disease.

For centuries now, researchers have been trying to get to the bottom of what causes and drives cancer. In 2005, the Cancer Genome Atlas project was launched. The goal was to identify genetic mutations or “cancer genes”.

500 samples from each of over 20 types of cancer were analysed. A wealth of new genes were found and the data helped reveal more of the “tricks” that cancer cells use to thrive in our bodies.

Although the project has certainly helped in the development of new drugs and the understanding of the disease, it looks like it’s like finding a needle in a haystack.

Scientists estimate that they need to examine about 100,000 cancer samples to find most of the genes involved in 50 cancer types. And we know that there are more cancer types than just 50- we have about 200 different types of cells in our bodies.

Wow, 100,000 cancer samples! That’s 10 times more than the $375 million Cancer Genome Atlas has analysed so far…

As much respect as I have for this kind of research, we have to wonder why cancer rates are still soaring. And put some money into prevention.

Yes, of course, survival rates have improved and there are treatments available now that save lives.
But… this brings me back to the initial question: Is cancer really a purely genetic disease and is it right to invest so much money into getting to the bottom of this?

The answer probably is that cancer isn’t just a genetic, but also a metabolic disease. And that there’s more than we thought we can do for prevention. We’re not just at the mercy of our genes!

It’s likely a “chicken or egg” situation- what comes first? Metabolic derangement that leads to genetic mutations or genetic mutations that lead to abnormal cell metabolism?

There is certainly evidence for both. AND we can’t forget we also have to consider what’s going on in the immune system and the immediate environment of the tumour. It is likely that depending on the type of tumour, there are various degrees of all the issues outlines above.

And therefore, different type of tumours need different type of treatments

My tumour, for instance, seems to respond particularly well to metabolic therapy, i.e. the ketogenic diet.

Pre-clinical trials, research into metabolism of cancer cells and animal studies show promising results for the ketogenic diet. Not necessarily as a cure for cancer (although in my case, it’s shown to have effects on my tumour that radiotherapy couldn’t achieve in the long term), but as an “adjunct” to conventional therapies, as oncologists call it.

But what exactly is an adjunct therapy?

It’s another treatment used together with the primary treatment, for instance radiotherapy or chemotherapy. The purpose of an adjunct is to assist the primary treatment. Ideally, it enhances the effects of it and minimises the side effects.

Despite all the promising data we still have a long way to go until the ketogenic diet can be and are waiting for the results of the first clinical trials. In summary, what we do know to date is that:

A ketogenic diet has been shown to be safe with a very low toxicity. What I’m very interested in is how safe and effective a ketogenic diet is in the long term.

There are numerous effects of a high-carbohydrate diet, e.g. high blood sugar, raised insulin levels or excess weight. These effects can lead to a higher rate of cancer. There is a brand new study confirming this.

Treatment outcomes in patients with high blood sugar levels are poorer. I think this is such an important point that I’m surprised it’s not taken into account more by medical professionals. However, I know for a fact that many patients coming back from cancer centres in Germany get a prescription for Metformin. This is a drug that is used for lowering insulin and blood sugar levels.

There is evidence that a ketogenic diet can help increase the effects of chemo- and radiotherapy. In my view, this is the most exciting area of research. We need more studies that investigate the effects of a protocol where diet and cancer treatments are used together.

When I was initially approached by clients to help them start the ketogenic diet, I was very reluctant to do so. Mainly because we do lack “hard facts” in the form of randomized controlled trials. But also because I saw the fast and powerful effects the diet had on my body and my tumour.

About 18 months ago, I was talking to a desperate patient who had found me online and who wanted to give the ketogenic diet a go under my guidance. I explained that I wanted to wait for results of clinical trials before I’d give anybody any professional support in this area.

She asked me how long it would take for the results of the clinical trials to come through. Unfortunately, this is always very hard to predict. Outcomes aren’t always made public straight away.

The lady I was talking to said that she couldn’t afford to wait for clinical trials and the approval of her oncologist. She wanted to start straight away and monitor the effects. What really convinced me to take her on as my first “ketogenic client” were the following word: “Okay, if you don’t give me guidance, I’m just going to try on my own and certainly mess things up a lot more than without your help.”

That’s when I realised that although I always try to be as scientific and evidence-based as possible, sometimes I have to accept that “evidence-informed” is all we have at the moment.

There is no doubt that the ketogenic diet and the foods we put into our mouths can have incredible effects on our bodies. And there is also no doubt that a ketogenic diet HAS to be more beneficial for a cancer patients than the Standard American or British Diet. I don’t need clinical trials to confirm this.

The lady I was talking to had a pretty poor diet before she was diagnosed: lots of processed foods (for instance chicken nuggets, frozen pies, ready-made curries), cakes, low-fat products, diet soda and very little home cooking. She was really motivated to completely change her diet and lifestyle.

That’s when I decided that she would be my first client I would guide through the ketogenic diet, how it is implemented and monitored. There couldn’t possibly be any harm done by helping her eat lots of real, fresh and nutritious foods.

Some of my clients have done incredibly well on the ketogenic diet- read this testimonial, for instance:

“I have [since] been told a professor of oncology that my disease is very unusual in that it is very slow growing, and he believes that it is the ketogenic diet that is creating this effect. With Patricia’s help, I have been able to change the course of my disease, and this has allowed me to stabilize my disease long enough to be able to receive some excellent new treatments. “

There are a number of “issues” with clinical trials into nutrition. They make it incredibly hard to assess the efficacy of a diet.

Finally, some “proper” phase I/II clinical trials are happening now into the ketogenic diet (and also fasting). You can go to www.clinicaltrials.gov, type in “ketogenic diet and cancer” and have a closer look. You will find for instance:

Ketogenic Diet With Radiation and Chemotherapy for Newly Diagnosed Glioblastoma, a phase I/II trial designed to test whether a ketogenic diet enhances the efficacy of radiation and chemotherapy.
I’m hoping that clinical data will be rolling in as soon as possible. If the results are as promising as the pre-clinical ones, there is hope that the medical profession will become more interested in nutritional topics- finally.

In the meantime, I keep researching, trying to understand metabolic pathways, cell signalling and other mechanisms that we can influence with diet. There are obviously not only trials into the ketogenic diet, but also how single foods like turmeric, exercise and other lifestyle choices can affect cancer cells.

The other thing I really want to talk about is that food and dietary choices should also be made to improve quality of life. Before I started to make big dietary changes, I had many digestive issues, hormonal imbalances and fatigue that really affected my daily life.

Seeing all these health issues disappear and feeling a lot better in myself is a huge bonus, and that’s what I see happening to many of my clients.

It’s not all about the tumour and cancer

It’s also about how you feel, whether you have the energy to go out, to exercise, to go on holidays without having indigestion, to get through the winter without chronic sniffles or whether anything is holding you back from leading a vital life.

About Patricia Daly

Patricia Daly is a fully qualified Nutritional Therapist (BA Hons, dipNT, mBANT, mNTOI) based in Dublin, Ireland. Following her cancer diagnosis, she left her corporate career and started studying nutrition, specialising in the area of Integrative Cancer Care. As a Swiss native, she regularly attends training courses in Switzerland/ Germany, including at the renowned Tumor Biology Center in Freiburg, Germany. Read More…